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Routine dental X-rays are not backed by evidence

arstechnica.com

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Re: Routine dental X-rays are not backed by evidence

#181

Current final year dental student pitching in here. While dentists of the past may push for unnecessary annual radiographs, the curriculum in dental school has changed to favour evidence-based dentistry. Annual bitewings are only indicated if you're a high caries risk, and, as the article mentions, 2-3 years if you're low caries risk. So your younger/newer dentist will be following much better protocols (and hopefull…

Slightly worrying that evidence-based dentistry wasn't the default position (though not surprising). I'm always kind of amazed that when I look up the robust evidence for even things as common as flossing, the evidence just...doesn't seem to be there. Let alone all the myriad of dental products from various mouth washes, tooth pastes, brushes and water picks. How we've ended up regulating medicine to the nth degree,…

There's some evidence if you know where to look for some of these things (i.e. the programme Dr. Ellie recommends on youtube does actually have papers backing what she says), but overall the dental industry has a long sordid history.

You don't understand the power of the ADA/flouride lobby.

Even just 20 years ago it was routine to have mercury (toxic heavy metal) placed in your mouth for fillings, evidence said the compounds were stable and no one would fund anything that rocks the boat in the US. They did that for children, but they didn't call it mercury, they called it silver fillings (50% by weight mercury).

Normally flouride has very limited uses prior to government mandates, and was so common that it was largely considered a waste by-product not worth selling.

I've yet to find an evidence based study or information on why government require flouride ingestion in any population center above 30,000 when studies have shown its just as effective topically. A study out of african really put the nail in the coffin on this one.

Side effects include lethargy, neurological damage, cognitive decline, hypertension, acne, seizures, and gastrointestinal issues.

It also damages your kids brains more than an adult brain (seemingly lowering IQ permanently), can't be filtered out except by specialized filters that cost a lot (and rapidly become less effective over time).

If they get too much which is very simple indeed, this can happen since its in everything (even bottled water and sodas, GRAS and no label needed under a certain concentration that's well above the toxic limits of new studies).

Nursery Purified bottled Water for infants is a primary source of business.

https://www.readyrefresh.com/medias/sys_master/images/images...

Makes you wonder what's really going on, and why they have to drug broad swaths of the population under the guise that it helps fight dental decay (through ingestion), when most of those studies have been debunked outside the US.

When cities don't have the funding, they magically get the funding for it. When local municipalities don't keep the levels up, they go after them heavy handed, and they disappear from public view.

https://ntp.niehs.nih.gov/whatwestudy/assessments/noncancer/...

Re: Routine dental X-rays are not backed by evidence

#182
When I'm told it's time for my annual x-ray, I usually ask them to delay it to next visit. That way I'm only getting them every 18 months. Seems to work out fine and they don't have a problem with it. I'd be hesitant to go 2-3 years between because I have had cavities in the past due partially to having pretty deep pits and fissures.

Re: Routine dental X-rays are not backed by evidence

#183
post #29

Isn't flossing not supported by science also, but all the news articles said you should keep flossing?

Completely anecdotal but my gums flare up and just feel disgusting when I don't floss for too long. I don't do the dentist recommended 2/week but if I stop flossing for over a month I notice significant decrease in my gum health. It becomes excruciatingly painful to brush and this stage and my mouth is full of blood afterwards. So I'm sticking to flossing pretty often now.

That does not sound normal.

Re: Routine dental X-rays are not backed by evidence

#184
post #145

Earlier quoted context omitted.

the studies are about outcomes of parachute use writ-large ("gravitational challenges"), not just helicopters. Only reason I'm being pedantic here is because if the study was in-fact looking at parachutes from helicopters, it could actually be plausible that parachutes had no improvements when used with helicopters. Most, if not all pilots, don't wear parachutes because there's not enough time to jump out of a crashi…

Interestingly helicopters don't fall out of the sky when they lose power. Air moving over the rotorblades causes lift, as they are after all wings. During normal flight the blades are turned by the engine generating lift in the expected way. If you are already above the ground and start descending, the airflow over the blades as you descend will cause them to rotate and generate lift. This is known as autorotation[0]…

[deleted]

Re: Routine dental X-rays are not backed by evidence

#185

You might be surprised that treatment recommendations vary dramatically from one dentist office to the next. [1] I am glad to know this about X-rays as well- it’s probably a useful indicator that if X-rays are not overprescribed the dentist will more likely not over treat. And if they react defensively to being told you want to follow the ADA guidelines that’s probably a sign they don’t think about whether they are o…

Two stories.

1) Just yesterday I went to a an acclaimed dental school (UNC) for low cost dental care. They not only gave me a panoramic x ray but also a full set of bite-wing x rays. I read this and I want to break the world apart this morning.

2) When I was a child I kep needing root canals. It turned out our dentist was making these all up and was later found passed out from laughing gas in his office.

Re: Routine dental X-rays are not backed by evidence

#186

Earlier quoted context omitted.

You lost at "European" and "everywhere in EU". The system is different between countries. For example Poland covers free annual review and basic procedures. (even if it's worse quality than on a private insurance) You're just trolling or really misinformed.

You said the same thing I said... You only get basic care to survive, nothing else. The system is different but this aspect is pretty much the same everywhere around here.

Having a repeating free review and treatment is above basic care to survive. Both compared to many other places in the world now and historically.

Re: Routine dental X-rays are not backed by evidence

#187
post #141

Earlier quoted context omitted.

Bone graft and implant for a single tooth can be up to £9K...

For sure, stuff like implants, cosmetic dentistry, braces, crowns etc. still cost a non-trivial amount (though hopefully most are once in a lifetime things).

Yeah - I had a dental bone graft a few months back and I certainly hope its a once in a lifetime thing!

NB No criticism of the dentist that did it - took two dentists and an assistant nearly 5 hours and they have an impressive amount of kit...

Re: Routine dental X-rays are not backed by evidence

#188

Earlier quoted context omitted.

Here’s a good answer that tracks with what my parents, who are dentists, told me: https://www.reddit.com/r/explainlikeimfive/s/H4MsnWKatM > For the longest time, surgeons, dentists and optometrists weren't part of the medical profession. You'd have a barber who could give you a shave or pull your teeth, or a butcher who could cut up a hog, or cut off your gangrenous leg. Optometrists were craftsmen who made the spect…

Note that "optometrist" is distinct from "ophthalmologist", which is the actual eye doctor. The optometrist job is only about fitting glasses and contacts for near/farsightedness, while ophthalmologists can treat all manners of eye diseases. And the final form of dentists, oral-maxillofacial surgeons are an all in one and have to study general medicine, surgery and dentistry.

An optician fits lenses, an optometrist measures your vision (and can refer you to an ophthalmologist if they spot something unusual).

Re: Routine dental X-rays are not backed by evidence

#189

Earlier quoted context omitted.

Those prices are absurd. My whole annual check up including a digital X-ray, visual inspection, tartar removal, polishing, costs less than that. And that is in high cost Norway.

How much did it cost? If _much_ lower than 200 USD per visit in a very wealthy country, then I assume: (a) dentists don't make very much money. Less than 100K USD? (b) most of the work is done by poorly paid dental assistants (20 USD per hour or less). Running a high quality dental clinic is expensive, both for equipment and staff. How can it be so cheap in Norway?

Higher education in Norway is free so a dentist starts with much less debt to pay off. Also the income range in general is much narrower here. Mean income for dentists is about 900 kNOK/yr, about 90 kUSD.

I suspect that it's also a question of market forces. A dentist that charged much more for an annual check would simply lose that business as there are plenty of dentists here. And quite likely they would lose any follow up work as well.

The profit margin on treatment is much higher but even that seems cheaper than what some of my US friends say they pay (or their insurance pays). Here's the price list for my dentist. In Norwegian but Google Translate does a good job:

http://www.drammen-tannlegesenter.no/om-oss-priser/priser

They do some cosmetic work as well, I imagine that the profit margins are higher for that.

I have two crowns, both created by an automated process of 3D photography and CNC machine in the clinic (Cerec). The most recent one went like this: I made an appointment to see my dentist at about 8:30 one morning complaining of toothache, she discovered that an old amalgam filling had cracked and taken part of the tooth with it and that the only practical repair was a crown. She then apologised profusely that she didn't have time to do it there and then but could I come back at 13:00 that afternoon? I said yes and by 13:30 the crown had been manufactured, fitted, ground down to an exact fit and I was leaving. The crown was a bit over 5 kNOK altogether, about 500 USD, for half an hour's work. The price has gone up a little since.

None of the work I have done, including the annual check-up, is done by a dental assistant, poorly paid or otherwise. I think that this might be because of the high cost of employing anyone in Norway.

Re: Routine dental X-rays are not backed by evidence

#190

You might be surprised that treatment recommendations vary dramatically from one dentist office to the next. [1] I am glad to know this about X-rays as well- it’s probably a useful indicator that if X-rays are not overprescribed the dentist will more likely not over treat. And if they react defensively to being told you want to follow the ADA guidelines that’s probably a sign they don’t think about whether they are o…

Two stories. 1) Just yesterday I went to a an acclaimed dental school (UNC) for low cost dental care. They not only gave me a panoramic x ray but also a full set of bite-wing x rays. I read this and I want to break the world apart this morning. 2) When I was a child I kep needing root canals. It turned out our dentist was making these all up and was later found passed out from laughing gas in his office.

I strongly suspect my dentist is making shit up, too. I had to refuse a couple of expensive treatments. The main goal seems to be to “use up” my dental insurance more than anything.
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